ISU study finds high heels may lead to joint degeneration and knee osteoarthritis

07-28-10

ISU kinesiology master's student Danielle Barkema (left)
and kinesiology professor and chair Phil Martin (right) used
sensors, accelerometers and lab equipment such as a force
platform and markers/cameras while testing subjects, like
kinesiology master's student Alison Glidden (center), in
their research on prolonged wearing of and walking in high
heels. Photo by Bob Elbert, ISU News Service (Download
print quality photo)

ISU study finds high heels may lead to joint degeneration and knee osteoarthritis

AMES, Iowa -- While women have been making a fashion statement
in high heels for years -- wearing trendy stilettos, wedges,
pumps and kitten heels -- there's reason for concern about
what those heels may be doing to their knees and joints over
time. A new study by an Iowa State University kinesiology
master's student has found that prolonged wearing of and
walking in high heels can contribute to joint degeneration and
knee osteoarthritis.

Danielle Barkema, the ISU student who is originally from Cedar
Falls, recently completed her thesis research studying the
effects of high-heeled walking on forces acting on lower
extremity joints. Kinesiology professor and department chair
Phil Martin assisted her in the study, which will be presented,
in part, at the annual meeting of the American Society of
Biomechanics (ASB), Aug. 18-21, at Brown University in
Providence, R.I.

"Obviously with research like this, you can't say with
any certainty that if you wear high heels regularly you will
develop osteoarthritis. We don't know that," Barkema
said. "There are probably people [high heel wearers] who
do and those who do not. However, based on this information,
wearing high heels puts individuals at greater risk for
developing osteoarthritis. And it seems to be that the higher
the heel height, the greater the risk."

Testing three heel heights

Barkema selected three different heel heights -- flat, two
inches, and 3.5 inches-- and had each of the 15 women in her
study complete walking trials. She measured the forces acting
about the knee joint and the heelstrike-induced shock wave that
travels up the body when walking in heels. Using sensors,
accelerometers and lab equipment such as a force platform and
markers/cameras, she was able to capture motion and force data
and translate them into results that could change the way
millions of women select their footwear.

While previous studies have examined the effect of high heels
on joints, the ISU researchers found that heel height changes
walking characteristics such as slower speeds and shorter
stride lengths. And as the heels got higher, they also saw an
increase in the compression on the inside -- or medial side--
of the knee.

"This means that prolonged wearing and walking in heels
could, over time, contribute to joint degeneration and knee
osteoarthritis," Barkema said.

"I think Danielle's exactly right. Wearing high heels
regularly puts a person at risk and the higher the heel, the
greater the risk," Martin added. "The loading
that's being produced in the joint with every step that
they take is higher -- or at least, these data suggest that.
These are not direct measures of loading within the joint, but
they're an alternative way of looking at that kind of
loading."

Barkema also found that in addition to lower extremity joint
problems, wearing heels - especially those two inches and
higher - alters body posture by changing joint positions at the
ankle, knee, hip, and trunk, which can create strain on the
lower back.

"Visually, it's quite apparent that somebody's
posture is altered when wearing high heels," she said.
"We noted those changes in posture [in the study], as well
as various joint angles, such as the knee and ankle angle. The
most dramatic change occurs at the ankle."

Research inspiration from her twin sister

The idea for the research thesis topic actually came from
Barkema's twin sister, Ashley, who saw the physical toll
regular high heel wear was having on her co-workers.

"Ashley began work as a retail manager at a well-known
department store in Chicago a few years ago," Barkema
said. "She, as well as most of her co-workers, wore high
heels on a daily basis. She noticed a lot of the women,
especially older women who had been wearing high heels
regularly, had various problems -- problems with their knees
and hips, etc."

Barkema's sister served as one of the subjects in the
study. And Danielle's not advising her sister to stop
wearing high heels altogether.

"I tell my friends to try to wear high heels in moderation
and, if possible, to wear lower heels," she said.

The research being presented at the ASB meeting will feature
one of the two parts of the study -- focusing on results on
tibia acceleration, or impact, in relation to heel height.
Those results curiously found the peak impact to be in the two
inch heels, with the higher heels actually diminishing the
impact similar to the flats.

The researchers plan to submit future papers on all their
findings to professional journals.

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Quick look

A new study by Danielle Barkema, an ISU kinesiology
master's student, has found that prolonged wearing of and
walking in high heels can contribute to joint degeneration and
knee osteoarthritis. Kinesiology professor and department chair
Phil Martin assisted her in the study, which will be presented,
in part, at the annual meeting of the American Society of
Biomechanics (ASB), Aug. 18-21, at Brown University in
Providence, R.I.

Quote

"Obviously with research like this, you can't say with
any certainty that if you wear high heels regularly you will
develop osteoarthritis. We don't know that. There are
probably people [high heel wearers] who do and those who do
not. However, based on this information, wearing high heels
puts individuals at greater risk for developing osteoarthritis.
And it seems to be that the higher the heel height, the greater
the risk."